Sunday, 24 June 2012

Heteromorphous Productions in the Heart

IN this text Austin Flint discusses Heteromorphous Productions, and enlargement of the heart. The text selected is from his book, A
Practical treatise on the diagnosis, pathology, and treatment of diseases of
the Heart. Second Edition. (Philadelphia
1870).

Heteromorphous Productions.—The
various morbid productions which, from their being foreign to the structure of the part in which they are seated, are distinguished
as heteromorphous, occur very rarely in the walls of the
heart. They are, however, sometimes observed. Specimens of
morbid growths or tumors, belonging to the classes lipoma or fatty,
fibroma or fibrous, myoma or fleshy, and syphiloma or gummy, are occasionally
met with. As stated by Raynaud, from their infrequency these are interesting
chiefly as pathological curiosities. They are
unattended by distinctive symptoms or signs, and they accordingly defy diagnosis.
In a practical point of view, therefore, they have
but little importance. Few organs in the body are more exempt from these, and
other heteromorphous productions, than the heart. So slight is the probability of their existence in any individual case, that they arc
scarcely to be taken into account in the investigation of cardiac
affections which are evidently anomalous. This statement will apply to
tubercles. Miliary tubercles are sometimes observed upon the surface of the heart; but collections of the
product known as yellow or cheesy tuberculous matter are amongst the rarest of pathological curiosities. (Page
123)

....

ENLARGEMENT OF THE HEART.

Definition and varieties of hypertrophy
and dilatation—Normal dimensions and weight of the
heart—Enlargement by hypertrophy—Concentrio hypertrophy—Symptoms and
pathological effects of hypertrophy—Physical signs
and diagnosis of enlargement and
hypertrophy—Situation and anatomical relations of the
heart in health—Alterations in degree and extent of dulness
on percussion in hypertrophy—Altered situation and extent of
the apex-beat, and abnormal force of impulse
in hypertrophy, as determined by palpation—Abnormal modifications of the heart-sounds—Diminished extent and degree of the respiratory murmur and vocal resonance within the
prsecordia in hypertrophy, as determined by auscultation—Results of the clinical study of the
heartsounds in health—Enlargement of the prsecordia
and abnormal movements in hypertrophy, as determined by inspection—Increased
size of the chest, as determined by
mensuration—Summary of the physical signs of enlargement of the
heart—Summary of the physical Bigns distinctive of enlargement by hypertrophy—Treatment of hypertrophy—Enlargement by dilatation—Symptoms and
pathological effects of dilatation— Physical signs
and diagnosis of dilatation—Summary of the physical signs distinctive of
enlargement by dilatation—Treatment of dilatation.

Enlargement Of Tiie Heart is a term which embraces abnormal
increase of this organ, as regards either volume or
weight, or, as is commonly the case, increase both in weight and volume.
Increase of the volume of the
heart, and increase of its weight, are different
forms of enlargement, either of
which, although they are usually associated, may exist independently of the other. The heart may exceed the limit of health, as regards weight, from an increased thickness
of its walls, the normal volume being retained.
This is a condition sometimes found after death, although, in the vast majority
of the cases in which the weight is augmented, the
volume exceeds the healthy limit. On the other hand, the volume of the heart may be abnormally great, the cavities being
enlarged, while the thickness of the walls is so
far diminished that the normal weight is retained. (Page 17)